中医针灸综合治疗肾虚督寒型强直性脊柱炎临床观察

Clinical Observation of TCM Acupuncture on Ankylosing Spondylitis of Kidney Deficiency and Cold Type

目的:探索中医养筋强督汤联合立极针法督灸治疗肾虚督寒型强直性脊柱炎(AS)的临床疗效,并观察患者临床症状及中医证候改善情况。方法:将120例肾虚督寒型AS患者按随机数字表法,分成对照组和治疗组各60例。对照组给予柳氮磺吡啶肠溶片口服治疗,治疗组在对照组治疗基础上加用养筋强督汤联合立极针法督灸治疗,两组均治疗8周,观察两组患者治疗前后中医证候积分、脊柱疼痛视觉模拟评分(VAS)、疾病活动指数(BASDAI)、躯体功能指数(BASFI)及血沉(ESR)、超敏C反应蛋白(hs-CRP)水平。结果:治疗8周后,治疗组患者总有效率为90.0%,明显高于对照组的总有效率(66.7%),P<0.05。治疗后,两组患者指地距、枕墙距、Sehober试验、晨僵持续时间较治疗前显著降低(P<0.01),治疗组改善更明显(P<0.01);两组患者中医证候积分、VAS评分、BASDAI评分、BASFI评分均较治疗前降低(P<0.01),且治疗组改善情况优于对照组(P<0.01);治疗后,两组患者ESR、hsCRP均较治疗前改善(P<0.01),且治疗组患者改善更为明显,差异有显著统计学意义(P<0.01)。结论:中医养筋强督汤联合立极针法督灸治疗肾虚督寒型AS临床疗效显著,可有效改善患者临床症状,提高脊柱功能,抑制炎症反应,安全性较高,有临床推广价值。

Objective:To explore the clinical effect of Yangjin Qiangdu decoction combined with Liji acupuncture and moxibustion in the treatment of Ankylosing Spondylitis(AS)with kidney deficiency and cold type,and to observe the clinical symptoms and TCM syndromes of patients.Methods:According to the random number table method,120 AS patients with kidney deficiency and cold type were divided into control group(60 cases)and treatment group(60 cases).The control group was given oral basic treatment with sulfasulazine enteric-coated tablets,and the treatment group was given Yangjin Qiangdu decoction combined with Liji acupuncture and moxibustion treatment,all of which were treated for 8 weeks.The levels of TCM syndrome score,visual analog scale(VAS),disease activity index(BASDAI),body function index(BASFI),erythrocytic sepulsation rate(ESR)and hypersensitive Creactive protein(hs-CRP)before and after treatment in 2 groups were observed.Results:After 8 weeks of treatment,the total effective rate of the treatment group was 90.0%,which was significantly higher than that of the control group(66.7%,P<0.05).After treatment,the digital ground distance,occipital wall distance,Sehober test and the duration of morning stiffness in 2 groups were lower than before treatment(P<0.01),and the improvement was more obvious in the treatment group(P<0.01).Compared with before treatment,TCM syndrome score,VAS score,BASDAI score and BASFI score in 2 groups were decreased(P<0.01),and the improvement in the treatment group was better than that in the control group(P<0.01).After treatment,ESR and hs-CRP in 2 groups were improved compared with before treatment(P<0.01),and the improvement in the treatment group was more significant,the difference was statistically significant(P<0.01).Conclusion:The combination of Yangjin Qiangdu decoction and Liji acupuncture and moxibustion for the treatment of kidney deficiency and cold type AS has a significant clinical effect,which can effectively improve the clinical symptoms of patients,improve the spinal function,inhibit inflammatory reaction,with high safety and clinical promotion value.